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Thyroid Gland
Dr Wale TITILOYE
Thyroid - Normal
Thyroid Physiology:
Hypothalamus
TRH
T3, T4
Pituitary
TSH
Thyroid
Role of Thyroglobulin
Role of Iodine
Release of thyroid hormones
Role of T3,T4 (transport via
transthyretin and thyroxine binding
globulin,binding to thyroid hormone
nuclear receptor, formation of thyroid
hormone receptor complex and
binding with thyroid hormone
response elements in target genes
and transcription.
Role of Goitrogens
Note the role of certain drugs
1. Propythiouracil- inhibit the oxidation
of iodide and block production of
thyroid hormones, inhibits the
peripheral deiodination of T4 to T3
2. Iodide administration(in large
quantity) to patients with thyroid
hyperfunction inhibit proteolysis of
thyroglobulin thus block release of
thyroid hormones
Disorders of Thyroid:
Hyperthyroidism
Hypothyroidism
Thyroiditis
Diffuse multinodular Goiter.
Neoplasms adenoma/carcinoma.
Congenital Thyroglossal cyst/duct.
Hyperthyroidism
Thyrotoxicosis
Hyperthyroidism
Features:
Graves Disease:
Morphology
Graves Thyroiditis:
Graves Disease
Hypothyroidism
Cretinism / Myxedema Low T3/T4, High TSH
Causes:
1. Hashimotos thyroiditis - autoimmune
2. Iodine deficiency
3. Drugs iodides, lithium
4. Developmental Atrophy, hypoplasia
Pituitary disorders
5. Radiation/Surgery
Hypothyroidism
Cretinism (child)
Impaired cns &
bone growth
Mental retardation
Short stature
Coarse facial
features
Protruding tongue
Umbilical hernia
Myxedema (adult)
Slow physical and
mental activity
Cold intolerance
Over weight
Low cardiac output
Constipation and
decreased sweating
Cool pale thick skin
Hypothyroidism
Myxedema
Features:
Thyroid Atrophy
Hashimoto Thyroiditis
Antithyroglobulin antibody
Antithyroid peroxidase antibody
Immunological mechanism
1. CD8+ cytotoxic T-Cell-Mediated cell
death
2. Cytokine mediated cell death
3. Binding of antibodies followed by
antibody mediated cytotoxicity
Morphology
Hashimotos Thyroiditis:
Hashimotos Disease
Hashimotos Disease
Antithyroglobulin Antibody
Antimicrosomal Autoantibody
Granulomatous Thyroiditis:
Multinodular Goitre
Neoplasms of Thyroid
Neoplasms of Thyroid
Adenoma
Follicular Adenoma
Follicular Adenoma
Solitary Adenoma
Follicular Adenoma
Thyroid Carcinoma
Thyroid Carcinoma
Type
% Age
Spread Prognosis
Papillary
Follicular
20 Middle age
B.V.
Good
Anaplastic 10 elderly
Local
Poor
Medullary 5
All
variable
Elderly
familial
Papillary Carcinoma
Papillary Carcinoma
Papillary Carcinoma
Medullary Carcinoma
Papillary Carcinoma
Anaplastic Carcinoma
Normal
Technetium
Scan
Hot nodules
Cold nodule
Ultrasound
Scan
Solid nodule:
Conclusions:
Hyperthyroidism
Graves, thyrotoxicosis, LATS.
Hypermetabolism, high T3/T4, low TSH
hypothyroidism:
C
A 25 year old presented with anterior neck swelling, exophthalmia and
pre-tibial myxoedema. Histology shows a diffuse hyperplasia of the
follicular cells with most of them having papillary folds and
thyroid
1. The
pathology of this disease is the presence of
contained scalloped pale scanty colloid. No capsular invasion was seen.